"Bound by law to offer gender affirming advice."

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WisNeuro said:
There are no tests that I have in my cabinet that do not also have general norms.
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WisNeuro said:
There are no tests that I have in my cabinet that do not also have general norms.
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So you don't have those tests. There are many that have gender norms. Srs, Anxiety, aggression tests etc
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Heist said:
So you don't have those tests. There are many that have gender norms. Srs, Anxiety, aggression tests etc
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Many tests have gender- or sex-based norms, but they often also have whole-sample norms or equivalent (or such published data can be found).

If there's a significant different between sexes/genders on testing, then as with anything else, it's ultimately up to the clinician to determine what tests to give and how to interpret them.
 
I have the SRS-2 in my arsenal of tests. I mainly use preschool form which has no gender differences in scoring. If I was using school-aged form with a client who identifies as a gender different from what was assigned at birth (and assuming I'd even know), I'd probably use the scoring form associated with the gender they identify with. I might even score it both ways just to see the differences. If client was of a sufficient developmental level to understand such things I'd discuss the issue with them. maybe there'd some slight inaccuracies with scoring, but for the incredibly small number that would be an issue it wouldnt be that big a deal. Malingering and demand characteristics of the items are more of a threat to validity than different gender norms would be. It's not unheard of (but not common) to get an SRS-2 result that seems totally out of line with my observations, other test results (e.g. ADOS-2; Vineland Socialization Scale). In those cases I deal with it how I see fit based on the client, then we all get on with our lives. I suppose I'd do the same with a client who identified with a gender different than they were born with. If my practice saw many of those types of clients, I'd probably avoid gender normed tests. Despite the large amount of attention this issue gets, base rates are so very low that it will not be issue for most of us (and I practice in an incredibly progressive leaning, LGBT acknowledging and friendly area- our city sidewalks are painted like rainbows!). When it is an issue, we will address threats to validity in our testing the way we always do (or should be doing), and there are more common threats that we deal with on a more regular basis.
 
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ClinicalABA said:
I have the SRS-2 in my arsenal of tests. I mainly use preschool form which has no gender differences in scoring. If I was using school-aged form with a client who identifies as a gender different from what was assigned at birth (and assuming I'd even know), I'd probably use the scoring form associated with the gender they identify with. I might even score it both ways just to see the differences. If client was of a sufficient developmental level to understand such things I'd discuss the issue with them. maybe there'd some slight inaccuracies with scoring, but for the incredibly small number that would be an issue it wouldnt be that big a deal. Malingering and demand characteristics of the items are more of a threat to validity than different gender norms would be. It's not unheard of (but not common) to get an SRS-2 result that seems totally out of line with my observations, other test results (e.g. ADOS-2; Vineland Socialization Scale). In those cases I deal with it how I see fit based on the client, then we all get on with our lives. I suppose I'd do the same with a client who identified with a gender different than they were born with. If my practice saw many of those types of clients, I'd probably avoid gender normed tests. Despite the large amount of attention this issue gets, base rates are so very low that it will not be issue for most of us (and I practice in an incredibly progressive leaning, LGBT acknowledging and friendly area- our city sidewalks are painted like rainbows!). When it is an issue, we will address threats to validity in our testing the way we always do (or should be doing), and there are more common threats that we deal with on a more regular basis.
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I like the tone of this post. Kind of reminds me of Taylor Swift, just need to calm down. Current generation is challenging gender and sexual norms probably moreso than anything else. Those have always been in flux and vary from culture to culture so probably not a very big deal in the scheme of things.
 
smalltownpsych said:
I like the tone of this post. Kind of reminds me of Taylor Swift, just need to calm down. Current generation is challenging gender and sexual norms probably moreso than anything else. Those have always been in flux and vary from culture to culture so probably not a very big deal in the scheme of things.
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Exactly. Let's also give ourselves some credit here- well trained, conscientious psychologists who use norm-referenced instruments should (and do, from what I see) always be considering the extent to which individual client characteristics compare to those of the normative sample. Read the damn technical and interpretive manuals! Get intimate with the psychometrics of the tests you use. Test construction is not just 10 questions on the EPPP that you plan on getting wrong!

Let's say we did get a client who identified with a gender different from the biological, binary gender applied at birth. I would make a decision (in concert with that client, if possible) which gender-norms would be most appropriate, as well as have a discussion about the pros and cons of each. I think it would also be interesting for all involved to see the different results from using the different gender norms. I really can't envision a scenario where, for example, a score would fall in the severe deficit range of the Social Communication Index of the SRS-2 using the male scoring sheet, yet would be in the mild or WNL range using the female one (which are blue and pink, respectively, which is pretty outdated if you ask me!). There may be some sway either way at the borders, but if you are using such things in exclusion for making decisions about diagnosis, placement, treatment planning, etc., you have bigger issues.
 
BuckeyeLove said:
I'm honestly amazed this issue hasnt come up more on any of they forensic listservs I'm on. Namely with SVT's.
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Depends on the SVT, but my experience with most of them is that there are no real differences when it's been assessed, or if there are, it's a very small effect size. And, given that the cut scores are generally set at either .90+specificity, or 5+SDs above the mean, these differences are meaningless when used to assess for validity.
 
Heist said:
So for the few tests with gender stratification what do you compare it to? They have non-binary norms etc?
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The psych field is on the sharp decline. You cant be taken seriously as a field when you begin to reject objective reality as a base line.
 
SomeGreatNotion said:
Title VII of the Civil Rights Act has protections on the basis of gender identity and sexual orientation. Very happy to disappoint you.
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Thats debatable. It certainly provides protection based on SEX however, it does not protect gender identity. Something that is so fluid and self-definitive is not protected. This is not to say that people should be A-holes to one another. Also, VII is employment protections.
 
Psychstudent!721 said:
Thats debatable. It certainly provides protection based on SEX however, it does not protect gender identity. Something that is so fluid and self-definitive is not protected. This is not to say that people should be A-holes to one another. Also, VII is employment protections.
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From the American Bar Association: "In a monumental decision from a trio of cases issued on June 15, 2020, the United States Supreme Court ruled that Title VII of the Civil Rights Act of 1964 prohibits discrimination on the basis of sexual orientation and/or transgender status"
 
SomeGreatNotion said:
From the American Bar Association: "In a monumental decision from a trio of cases issued on June 15, 2020, the United States Supreme Court ruled that Title VII of the Civil Rights Act of 1964 prohibits discrimination on the basis of sexual orientation and/or transgender status"
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Yes, I learned about this recently. Its heavily debatable as this is not the same as barring a jewish girl from playing on the local softball team because she is jewish. It will be interesting to see where it goes.
 
Psychstudent!721 said:
Thats debatable. It certainly provides protection based on SEX however, it does not protect gender identity. Something that is so fluid and self-definitive is not protected. This is not to say that people should be A-holes to one another. Also, VII is employment protections.
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It does in that gender identity and sexual orientation are inherently linked to sex--for example, a law, say, barring transgender women from employment is placing only people whose sex was determined as male at birth (interestingly, there are actually a decent amount of people who are intersex/have disorders of sexual development where their condition isn't diagnosed until later in life) at risk for discrimination for engaging in "female" gender expressions, whereas the same gender expression would be a-okay in someone whose sex at birth was determined to be female. Similarly, an employer firing a female employee for dating another women is discriminating on the basis of sex because they wouldn't fire a man for dating a woman. By narrowly defining "sex" as biological sex assigned at birth, the courts made the law expansive enough to cover gender identity and sexual orientation.

Again, I think a lot of these anti-trans issues are based in the "guy in a dress"/"girl who dresses like a guy" stereotype, where the issue people have isn't so much trans people as it trans people who don't pass or cis people who gender nonconfirming. No one would look askance at Hunter Schaffer (a trans woman) entering a women's bathroom, for example, or Laith Ashley (a trans man) entering a men's locker room and if they were to enter spaces designated for their sex assigned at birth, the same people pushing for these anti-trans bills that would require them to do so would probably scream that they were entering the "wrong" rooms. What you overwhelmingly get with these bills is cisgender gender non-confirming people (a lot of butch women) and trans people who are early in their transition or who are otherwise clocked being attacked, because they don't fit into rigid sex stereotypes more than anything.

Sports are a bit hairier, because there are physical advantages to be pumped full of testosterone during male puberty, but the extent to which those advantages fade (or don't) with long-term T suppression and estrogen replacement is more of an open question for science, and it's also further complicated by the fact that elite athletes tend to have some biological traits on the far end of the curve regardless of if they are trans or not. Personally, I thought the NCAA's previous stance on athletes competing under their natal sex until they started HRT made sense--then it was a personal, informed choice for each athlete if they were willing and able to delay HRT to compete for longer or not.
 
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futureapppsy2 said:
Re: testing issues (@Fan_of_Meehl , @ClinicalABA , @WisNeuro )--this article is often cited as seminal on this topic:

Keo-Meier, C. L., & Fitzgerald, K. M. (2017). Affirmative psychological testing and neurocognitive assessment with transgender adults. Psychiatric Clinics, 40(1), 51-64.

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Thank you for the article, I actually overlapped with the lead author during my training. Decent overview, but pretty light on the neurocognitive piece. One thing I would like to see discussed, and researched, more is the potential for timing of transition to affect the development of some of the differences we see in cognition, as critical periods in development most likely play a role. Also, they should have probably just left out the DTI stuff, that literature is so far pretty experimental, and anything in the clinical realm using it is junk science. Most of the differences found between groups are extremely non-specific. For example, some of the DTI "differences" in mTBI are the same as we find in a sample fo non-traumatic TMJ sufferers, among other non-head injured clinical groups.
 
futureapppsy2 said:
Re: testing issues (@Fan_of_Meehl , @ClinicalABA , @WisNeuro )--this article is often cited as seminal on this topic:

Keo-Meier, C. L., & Fitzgerald, K. M. (2017). Affirmative psychological testing and neurocognitive assessment with transgender adults. Psychiatric Clinics, 40(1), 51-64.

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Thanks. I am always struck by the dichotomy between how basic it sounds to say "clinicians without experience with this population should seek out supervision/consultation from a clinician who is" and the practical realities of doing so. What would that supervision/consultation entail? I would clearly (ethically) need to inform the client that I don't have the necessary experience for their case and would be getting supervision. I guess, from the standpoint of what is best for that client, if I have access to supervision from a trained clinician, should I not refer them to that clinician (especially in this age of telehealth availability)? I could see the argument for increasing the capacity to serve this population if that were truly a goal, but you'd need to be really transparent about this with the client. I'd worry that, firstly, I would worry that I my lack of experience would a) put that client at risk; and b) put me at risk should something go wrong. Have any of you been involved in this type of scenario as a licensed practitioner, where you've taken on a client/issue that you don't have appropriate experience for under the supervision of another licensed professional? What risks are legally assumed by the supervisor? How do you document those risks? Why did you not refer the client to an appropriately experienced clinician? At what point (e.g., number of referrals of this type; lack of qualified providers in the community to refer to, etc.) would you make a decision that you need to expand you clinical skills to be better able to address this need?

Because of the age of my clientele (toddler-preschoolers), and despite fear-mongering about trying to "recruit" children to this "lifestyle," I am not likely to have to face this issue personally. I do encounter similar issues regarding language and culture with the families I work work with, and there are literally NO other available clinicians to do what I do (and accept their insurance) within a 75-mile radius, so I've had to get consultation from community members on the cultural aspects that I'm not aware of, as well as consult with an occasional clinician regarding clinical issues, but I don't see the risks to the client or myself being as significant.
 
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futureapppsy2 said:
It does in that gender identity and sexual orientation are inherently linked to sex--for example, a law, say, barring transgender women from employment is placing only people whose sex was determined as male at birth (interestingly, there are actually a decent amount of people who are intersex/have disorders of sexual development where their condition isn't diagnosed until later in life) at risk for discrimination for engaging in "female" gender expressions, whereas the same gender expression would be a-okay in someone whose sex at birth was determined to be female. Similarly, an employer firing a female employee for dating another women is discriminating on the basis of sex because they wouldn't fire a man for dating a woman. By narrowly defining "sex" as biological sex assigned at birth, the courts made the law expansive enough to cover gender identity and sexual orientation.

Again, I think a lot of these anti-trans issues are based in the "guy in a dress"/"girl who dresses like a guy" stereotype, where the issue people have isn't so much trans people as it trans people who don't pass or cis people who gender nonconfirming. No one would look askance at Hunter Schaffer (a trans woman) entering a women's bathroom, for example, or Laith Ashley (a trans man) entering a men's locker room and if they were to enter spaces designated for their sex assigned at birth, the same people pushing for these anti-trans bills that would require them to do so would probably scream that they were entering the "wrong" rooms. What you overwhelmingly get with these bills is cisgender gender non-confirming people (a lot of butch women) and trans people who are early in their transition or who are otherwise clocked being attacked, because they don't fit into rigid sex stereotypes more than anything.

Sports are a bit hairier, because there are physical advantages to be pumped full of testosterone during male puberty, but the extent to which those advantages fade (or don't) with long-term T suppression and estrogen replacement is more of an open question for science, and it's also further complicated by the fact that elite athletes tend to have some biological traits on the far end of the curve regardless of if they are trans or not. Personally, I thought the NCAA's previous stance on athletes competing under their natal sex until they started HRT made sense--then it was a personal, informed choice for each athlete if they were willing and able to delay HRT to compete for longer or not.
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futureapppsy2 said:
It does in that gender identity and sexual orientation are inherently linked to sex--for example, a law, say, barring transgender women from employment is placing only people whose sex was determined as male at birth (interestingly, there are actually a decent amount of people who are intersex/have disorders of sexual development where their condition isn't diagnosed until later in life) at risk for discrimination for engaging in "female" gender expressions, whereas the same gender expression would be a-okay in someone whose sex at birth was determined to be female. Similarly, an employer firing a female employee for dating another women is discriminating on the basis of sex because they wouldn't fire a man for dating a woman. By narrowly defining "sex" as biological sex assigned at birth, the courts made the law expansive enough to cover gender identity and sexual orientation.

Again, I think a lot of these anti-trans issues are based in the "guy in a dress"/"girl who dresses like a guy" stereotype, where the issue people have isn't so much trans people as it trans people who don't pass or cis people who gender nonconfirming. No one would look askance at Hunter Schaffer (a trans woman) entering a women's bathroom, for example, or Laith Ashley (a trans man) entering a men's locker room and if they were to enter spaces designated for their sex assigned at birth, the same people pushing for these anti-trans bills that would require them to do so would probably scream that they were entering the "wrong" rooms. What you overwhelmingly get with these bills is cisgender gender non-confirming people (a lot of butch women) and trans people who are early in their transition or who are otherwise clocked being attacked, because they don't fit into rigid sex stereotypes more than anything.

Sports are a bit hairier, because there are physical advantages to be pumped full of testosterone during male puberty, but the extent to which those advantages fade (or don't) with long-term T suppression and estrogen replacement is more of an open question for science, and it's also further complicated by the fact that elite athletes tend to have some biological traits on the far end of the curve regardless of if they are trans or not. Personally, I thought the NCAA's previous stance on athletes competing under their natal sex until they started HRT made sense--then it was a personal, informed choice for each athlete if they were willing and able to delay HRT to compete for longer or not.
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We're conflating a lot of things under the category of "gender identity". I do not believe gender identity is not inherently linked to sex (biologically speaking). Of course it also matters how youre defining "gender identity". Sex is not determined at birth, it is observed and intersex and other exceedingly rare genetic mutations or abnormalities (not to be pejorative) does not negate this. To lump intersex individuals and people with sexual disorders and genetic disorders such as kleinfelters syndrome in with trans and gender identity is not correct in my estimation, I could be wrong. However, we also have an issue because *****s lack the capacity to understand that while sex is largely 99.9% (or close to it) either male or female there are outliers where mutations arise (scientifically speaking) and we must, living in the 21st century, move away from ignoring the struggles these individuals face simply because they're a very small number.

I disagree with you on the trans bill statement, respectfully speaking. I don't believe these are "anti-trans" issues nor "guy in a dress" stereotype. It is more so that there is a real threat of truly sick people using the compassion we both have for people to live in accordance with how they see fit that they will not think twice of using subjective self-identification of gender to gain access to women and children. We have seen before and are now seeing it with male criminals identifying as the opposite sex in order to avoid prison with a male population and then get placed with females where they then go on to sexual assault and impregnate female inmates. Most of whom already have a traumatic history of SA.

The issue really comes to the middle ground, how do we respect the rights of biological women and girls as well as people who are ACTUALLY trans. The other issue is how do we grapple with rapid onsent of gender dysphoria and the social contagen component? Trans is not new but is oddly SKYROCKETED in less than 10 years ( no I do not believe this is because of a new found acceptance). We also have to be careful because A LOT of people will take any opportunity to use research without even understanding it to say "see, trans doesnt exist!" and push their bigoted views.

One giant controversy, like you said, IS the issue of sports. Leah Thomas goes all through life without any signs of GD (to my knowledge) and after placing less than 30th as a male swimmer decides to identify as female and breaks every female record by at least 50 seconds and becomes number one in the nation? Thats wrong. It is also wrong to work to take away gender treatment from consenting ADULTS. There are bad actors on both sides that make it a minefield to navigate from pronouns usage being equated to violence to very conservative religious fundamentalists thinking being gay is the work of the devil and trans is worse.

There is a very hard issue here where the answer is not blanket acceptance in the name of compassion nor is the answer harsh bans. For example, were starting to see some research come out from the UK and Netherlands that suggest a rapid push to transition young people is not the best course of action as it actually worsens mental health with no clinically significant improvement. However, it is nearly impossible to do actual research in the U.S due to stigma and concerns over how the results will be used. This is an issue I fear has been far too politicized by activists AND actual anti-trans people that make it almost impossible to view the matter objectively in anyway.
 
Psychstudent!721 said:
.. It is more so that there is a real threat of truly sick people using the compassion we both have for people to live in accordance with how they see fit that they will not think twice of using subjective self-identification of gender to gain access to women and children...
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You have appealed to my emotions. I certainly don't want sicko men attacking my women and children under the guise of being a a woman themselves! What, however, is the evidence that this is actually happening at alarming rates due to gender affirming care or that sickos would be less likely to commit such atrocities if we outlawed gender affirming care? I live in one of the most LGBT friendly areas of the world, and not only are there not high rates of such atrocities, there's not even low rates of such atrocities.
 
In an earnest effort to gain more information on this dangerous situation (as well as to keep the bit going) I did some research. It turns out that there IS a pretty significant relationship between transgender individuals and sexual/other assault in gender specific bathrooms. I will immediately be contacting my state and national elected officials to demand that they enact legislation to keep my non-binary family and friends from becoming one the approximately one third of such individuals who report being assaulted using the bathroom designated for their gender as assigned at birth rather than the one they identify with currently.

The data is even scarier! It turns out that sicko sexual deviants are masquerading in many of our respected institutions where rates of sexual assault are even higher than the statistically-equal-to-zero rates we see from men masquerading as women. I will also be requesting that my officials propose legislation to outlaw relatives baby sitting, youth sports (especially gymnastics and swimming), the catholic church, and the practice of adult outpatient psychology. Please let me know if I missed something- you can't be too careful!

ETA- I have also seen some of my fellow concerned citizens shooting or running over cases of Bud Light. I can only assume that they have seen the literature on the relationship between alcohol consumption and sexual assault and are taking it in their own hands to do something about it.
 
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Psychstudent!721 said:
We're conflating a lot of things under the category of "gender identity". I do not believe gender identity is not inherently linked to sex (biologically speaking). Of course it also matters how youre defining "gender identity". Sex is not determined at birth, it is observed and intersex and other exceedingly rare genetic mutations or abnormalities (not to be pejorative) does not negate this. To lump intersex individuals and people with sexual disorders and genetic disorders such as kleinfelters syndrome in with trans and gender identity is not correct in my estimation, I could be wrong. However, we also have an issue because *****s lack the capacity to understand that while sex is largely 99.9% (or close to it) either male or female there are outliers where mutations arise (scientifically speaking) and we must, living in the 21st century, move away from ignoring the struggles these individuals face simply because they're a very small number.

I disagree with you on the trans bill statement, respectfully speaking. I don't believe these are "anti-trans" issues nor "guy in a dress" stereotype. It is more so that there is a real threat of truly sick people using the compassion we both have for people to live in accordance with how they see fit that they will not think twice of using subjective self-identification of gender to gain access to women and children. We have seen before and are now seeing it with male criminals identifying as the opposite sex in order to avoid prison with a male population and then get placed with females where they then go on to sexual assault and impregnate female inmates. Most of whom already have a traumatic history of SA.

The issue really comes to the middle ground, how do we respect the rights of biological women and girls as well as people who are ACTUALLY trans. The other issue is how do we grapple with rapid onsent of gender dysphoria and the social contagen component? Trans is not new but is oddly SKYROCKETED in less than 10 years ( no I do not believe this is because of a new found acceptance). We also have to be careful because A LOT of people will take any opportunity to use research without even understanding it to say "see, trans doesnt exist!" and push their bigoted views.

One giant controversy, like you said, IS the issue of sports. Leah Thomas goes all through life without any signs of GD (to my knowledge) and after placing less than 30th as a male swimmer decides to identify as female and breaks every female record by at least 50 seconds and becomes number one in the nation? Thats wrong. It is also wrong to work to take away gender treatment from consenting ADULTS. There are bad actors on both sides that make it a minefield to navigate from pronouns usage being equated to violence to very conservative religious fundamentalists thinking being gay is the work of the devil and trans is worse.

There is a very hard issue here where the answer is not blanket acceptance in the name of compassion nor is the answer harsh bans. For example, were starting to see some research come out from the UK and Netherlands that suggest a rapid push to transition young people is not the best course of action as it actually worsens mental health with no clinically significant improvement. However, it is nearly impossible to do actual research in the U.S due to stigma and concerns over how the results will be used. This is an issue I fear has been far too politicized by activists AND actual anti-trans people that make it almost impossible to view the matter objectively in anyway.
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Intersex people are not the same as trans people, of course, and I never said that. The point is simply that how you identify "real" sex can be much blurrier than anti-trans folk admit. For example, they often say "it comes down to chromosomes", but if you have someone with androgen insensitivity syndrome, they have XY chromosomes but their genitalia at birth appears female, so are they "really" male or female? Would you go by external appearance? Identity? If so, why wouldn't you go by external apperance for a trans man or trans woman who appears to be male or female? No one is going to look at Hunter Schaffer and say "that's a man" or Laith Ashley and say "that's a woman" and if people were to see Laith Ashley in a women's bathroom, they would probably think "a man is using the women's bathroom!" not "yeah, that's a woman using the 'correct' bathroom." So, how "passable"/gender conforming do you have to be to be "really" male or female? I have a butch cisgender female friend who was sometimes mistaken for male during COVID due to masks and having smaller breasts. Should she have been using the men's bathroom because people might have mistaken her as a "male predator" in the women's bathroom? Again, what we've largely seen with bathroom bills in action is gender non-conforming cis people being attacked for following the law, which raises the question of where should they go to the bathroom? Should they even leave the house if they might be mistaken as trans?
 
futureapppsy2 said:
... Should they even leave the house if they might be mistaken as trans?
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I think a lot of folks would privately argue "no", but publicly throw out some bogeyman arguments about dangerousness, uncertainty, extreme examples, etc. You hit the nail on the head a few posts back- it's an issues of gender non-conformity for many, rather that transgender. If you look the way a woman is "supposed" to look or the way an man is "supposed" to look it's not that big an issue.

I do get it, though. If, like me, you were raised in a different time or place, it may have been unusual to encounter gender non-comformity. It may look different than you are used too, it may lead to your kids asking questions that you cannot readily answer. Things that are different are often somewhat uncomfortable or a bit scary- that's a pretty natural human reaction. It is problematic that admitting to these human reactions can lead to undue censure or persecution, rather than education. It should be ok for people to come out and admit that "it just makes me uncomfortable" as long as they follow-up with "can you help me be more comfortable about it," rather than just "can you make it go away."
 
borne_before said:
Personally, I'm not a huge fan of the term gender. I think it's nebulous, and appears to function much like a soul/id/ego/superego. I do like the term gender expression. If gender hints at an inborn feeling - how does feeling male or female feel?

Edit: I will make a long term prediction - the term gender will be looked at similarly to how we view id/ego/superego currently. It won't be the only way to analyze behavior once the science catches up.
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Largely irrelevant and tenuously supported by empirical evidence?
 
borne_before said:
"Fifty-three percent of the mothers of boys with GID compared with only 6% of controls met the diagnosis for Borderline Personality Disorder"

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From the article, re: the interviews from which the BPD diagnoses were made: "The interviews in this study were not blind and were conducted by the first author." That's HUGE threat to internal validity. Furthermore, history of psychiatric treatment referral was an exclusion criteria for boys in the control group (ETA- I just reread article and noticed that there were no such exclusion criteria for GID proband!) Another big threat to internal validity. N of 16 for mothers of boys with GID, sequentially self--referred to author's clinical practice. Non-parametric analysis. Authors themselves refer to this as a pilot study. I'd be really cautious drawing any conclusions from this study. Non-blind diagnostic interviews and potentially innappropriate control group are BIG problems and may not pass muster for a thesis/dissertation in my experience.
 
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borne_before said:
now try steelmanning the ariticle
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This would not be possible, as you just presented an article without presenting any argument or position for which you were using the article for support. Steelmanning would involve "attacking" the article whilst not addressing your overall position. As no overall position was presented, I could neither address nor fail to address it. Thus, my reply was nothing more than a pure criticism of the article. If you want to give me your position so that I can attempt to construct a steelman argument, I'd legitimately be happy to try. It's a pretty difficult logical fallacy to pull off, so I'd appreciate the practice!

Note that in my criticism of the article, I did not make any statements regarding the relationship between GID boys and BPD moms. That was deliberate. The real issue with with such threats to internal validity is that they can't demonstrate a functional relationship between the IV and the DV, not that they don't.

My hunch with that study is that they are picking up somewhat on the relationship between severe MI in the children of parents with severe MI. Given the non blindness of the BPD diagnostic interviews, we can't be certain of the validity of the BPD diagnoses in the moms, but Id be surprised if there weren't higher rates of some MI, as they are first degree relatives of boys receiving inpatient psychiatric care. The presence of non-GID MI in the boys was not controlled for. Thus-at best- this study is really only testing for wether or mot MI runs in families. Again- Given the small n and non-blindness of the major measure of the DV, I'm not really certain it could do that.
 
ClinicalABA said:
This would not be possible, as you just presented an article without presenting any argument or position for which you were using the article for support. Steelmanning would involve "attacking" the article whilst not addressing your overall position. As no overall position was presented, I could neither address nor fail to address it. Thus, my reply was nothing more than a pure criticism of the article. If you want to give me your position so that I can attempt to construct a steelman argument, I'd legitimately be happy to try. It's a pretty difficult logical fallacy to pull off, so I'd appreciate the practice!

Note that in my criticism of the article, I did not make any statements regarding the relationship between GID boys and BPD moms. That was deliberate. The real issue with with such threats to internal validity is that they can't demonstrate a functional relationship between the IV and the DV, not that they don't.

My hunch with that study is that they are picking up somewhat on the relationship between severe MI in the children of parents with severe MI. Given the non blindness of the BPD diagnostic interviews, we can't be certain of the validity of the BPD diagnoses in the moms, but Id be surprised if there weren't higher rates of some MI, as they are first degree relatives of boys receiving inpatient psychiatric care. The presence of non-GID MI in the boys was not controlled for. Thus-at best- this study is really only testing for wether or mot MI runs in families. Again- Given the small n and non-blindness of the major measure of the DV, I'm not really certain it could do that.
Click to expand...

How dare you use logic and a basic understanding of research methods!
 
WisNeuro said:
How dare you use logic and a basic understanding of research methods!
Click to expand...
I will hold off on judgment of the intent of @borne_before's comment- I'm just not sure what they were getting at. Were they accusing me of steelmanning? merely suggesting I give it a try?

I do, however, enjoy (probably a little too much) logic and criticizing questionable research articles! In my "real life," I even get paid to do it.
Seriously, though- if any of my critiques of that study are unfounded, I really would like to know so that I can be better next time.
 
ClinicalABA said:
I will hold off on judgment of the intent of @borne_before's comment- I'm just not sure what they were getting at. Were they accusing me of steelmanning? merely suggesting I give it a try?

I do, however, enjoy (probably a little too much) logic and criticizing questionable research articles! In my "real life," I even get paid to do it.
Seriously, though- if any of my critiques of that study are unfounded, I really would like to know so that I can be better next time.
Click to expand...

No, I thought you were pretty spot on. Hard to extrapolate to the general population based on a self-referred SMI sample that is an N of 16.
 
borne_before said:
No they're pretty spot on. I just meant, it's easy to criticize an article but in certain twitter spaces it's used for a certain agenda. But, does it provide any value?
Click to expand...

Given its methodological limitations and how much has changed in our understanding within the area since the late 80's/early 90's when the author wrote it, I can't see what use it serves for understanding anything of value.
 
borne_before said:
Maybe a spark for future research with more improved controls? I'm gonna look at it's citation history.
Click to expand...

Sure, if it were designed and powered well. I imagine you'd have to expand the scope a bit as well.

BuckeyeLove said:
The fact this article is being thrown around on twitter as substantive evidence of a problem (with great vigor and reach by these twitter personalities) is legit concerning.
Click to expand...

Have you been on Twitter? The general populace there are functionally troglodytes. Even the professional subs are pretty ignorant. Have you seen the private psychotherapy sub? After seeing the "professionals" on there, I am no longer surprised at the state of this country's mental health.
 
borne_before said:
Dude, I get this sentiment. But, I truly think that steelmanning - knowing the other's arguments as good as your own, is the best way to fruitful convos. Plus add a little sugar in there and you might start a change.
Click to expand...

There is very little redeemable value in discourse on Twitter. 99.99% of the "arguments" on twitter simply have little to no factual basis. I hardly see the value in knowing various delusions.
 
borne_before said:
No they're pretty spot on. I just meant, it's easy to criticize an article but in certain twitter spaces it's used for a certain agenda. But, does it provide any value?

Btw - my four year old was bullying me when I replied to that and my comment was cut short. I needed to open a can whoopass. Sorry for the short reply. The little hobgoblin thinks it's so funny to launch himself onto me while I'm on the couch knee first.
Click to expand...
My agenda in criticizing this article was to criticize the article. As I mentioned, I enjoy article reviews (and I currently teach graduate courses in research methods and experimental analysis of behavior, so it's good practice). I have a very low opinion of this article and do not think it provides much value. The non-blindness and inadequate (dare say "biased") control group are fundamental flaws that introduce a whole bunch of confounds that make any real conclusions impossible.

Also- you have actually left off a bit in your quote of the findings (I hope not intentionally). The full quote is: "Fifty-three percent of the mothers of boys with GID compared with only 6% of controls met the diagnosis for Borderline Personality Disorder on the Diagnostic Interview for Borderlines or had symptoms of depression on the Beck Depression Inventory." That last bit following the "or" is kind of important. Only 25% (4 out of 16) met criteria for BPD. The rest scored higher on the BDI. With a subject pool of 16, how do you get 53%? 8 would be 50%, and 9 would be 56% after rounding. I'll assume they meant 56% (or I'm not smart enough to figure out the maths here), and thus we have a total of 4 BPD moms and 5 high BDI moms. Is 4/16 with BPD vs. 1/17 with BPD from the control really all the practically significant? In regards to the BDI results, wouldn't you be surprised if moms of children in an inpatient psychiatric facility didn't score higher on the BDI than moms of non-psychiatrically involved children (who the authors refer to as "normal", but that's a whole other discussion😉)?

Getting their conclusions/discussions, they don't even that it is a correlational study and that there is no way to determine the directionality of the the effects they believe they see. They go right to a psychodynamic interpretation of causality (cross gender behavior is a defense of separation anxiety), with no acknowledgment that BPD could be a "defense" of- I don't know- fears of losing a child (as you may guess, I'm not up to date on my Freud). This one is BAD all around. It's one thing to identify limitations of a study in the conclusions, and even to label it a pilot study. It's- IMHO- very bad form when those limitations render any findings moot. Shame on the editorial board for this one.
 
Last edited:
Heist said:
Did anyone look at the article I posted by bmj that was recent?
Click to expand...
I did. It's more of a position piece than a research article. I agree that it is important to be cautious with medical interventions and decisions really need to be made from an informed position where the benefits outweigh the costs. I do think that article presented stuff in a manner that overly equated "gender affirming care" with medical interventions (such as hormone replacement and surgery). There is certainly a lot of space between irreversible medical interventions and just telling kids to knock it off and start acting like a boy/girl. I have been pretty vocal against legislating against gender affirming care, but even I would say to proceed cautiously with medical interventions (especially irreversible ones) without some measure of certainty. Also- it's not terribly surprising/interesting to see increased professional disagreement when a topic becomes more popular, so to speak.

I was also struck by the following statement and how it applies to a lot of what I/we do:

"But without an objective diagnostic test, others remain concerned, pointing to examples of teenagers being “fast-tracked to medical intervention” with little or no mental health involvement. "

I bet I could show just that statement to 10 different psychologists and ask them to identify the topic/condition it referred to and I'd get around 5 different answers (e.g., ADHD, Bipolar, NSSI, even ASD). Problem is, at least with gender dysphoria, waiting for more more objective tests before doing anything can be untenable for many such individuals and lead to tragic outcomes.

I guess I would some up my position on this issue as follows: Individuals presenting to psychologists with gender dysphoria should be treated respectfully and cautiously, with some acknowledgement that issue really could be with the body and not the brain. These individuals should be referred to a clinician with appropriate training and experience in working with the psychological issues related to the empirically supported treatment of gender dysphoria (with some acknowledgement of the evolving nature of that research. Where such other clinicians are not readily available, the original clinician should work with the individual to identify and address and related or secondary concerns/co-existing conditions, emphasizing safety, without taking much of a stance on the gender dysphoria issue. Psychologists with appropriate training and experience should work closely with medical professionals who may or may not need to get involved with the case. Any planning for medical interventions should be done only following appropriate, research supported (with consideration to for the evolving state of such research) non-medical care. Because I am not up on the literature, I don't really have a firm stance on what should be done relative to non-adjudicated minors and medical interventions. Assuming- and maybe incorrectly- that nothing is done pre-pubescent- we are really talking about that aged 10-18 group. My reading of the literature would indicate that that is a VERY small portion of the population receiving any gender dysphoric related medical interventions.

I believe that the positions and behaviors of certain politicians (and others) is related to morals/religion/tradition/fear/etc., rather than any understanding of the actual clinical issues, effects of treatment/no treatment. I also believe that many of these same individuals purposefully equate gender affirming care with gender reassignment surgery, and wrongfully allude to such surgeries being performed on children. Further, i believe that many of these individuals (especially the politicians) due so to primarily to strengthen their own political standings with certain parts of the populace and have no real concern for the people affected by these policies. I also believe that there are psychologists and others who overstate the actual research findings (in both directions) to make it appear that their moralistically or religiously derived positions have more empirical support than they actually do. Some do so more intentionally than others.
 
ClinicalABA said:
I did. It's more of a position piece than a research article. I agree that it is important to be cautious with medical interventions and decisions really need to be made from an informed position where the benefits outweigh the costs. I do think that article presented stuff in a manner that overly equated "gender affirming care" with medical interventions (such as hormone replacement and surgery). There is certainly a lot of space between irreversible medical interventions and just telling kids to knock it off and start acting like a boy/girl. I have been pretty vocal against legislating against gender affirming care, but even I would say to proceed cautiously with medical interventions (especially irreversible ones) without some measure of certainty. Also- it's not terribly surprising/interesting to see increased professional disagreement when a topic becomes more popular, so to speak.

I was also struck by the following statement and how it applies to a lot of what I/we do:

"But without an objective diagnostic test, others remain concerned, pointing to examples of teenagers being “fast-tracked to medical intervention” with little or no mental health involvement. "

I bet I could show just that statement to 10 different psychologists and ask them to identify the topic/condition it referred to and I'd get around 5 different answers (e.g., ADHD, Bipolar, NSSI, even ASD). Problem is, at least with gender dysphoria, waiting for more more objective tests before doing anything can be untenable for many such individuals and lead to tragic outcomes.

I guess I would some up my position on this issue as follows: Individuals presenting to psychologists with gender dysphoria should be treated respectfully and cautiously, with some acknowledgement that issue really could be with the body and not the brain. These individuals should be referred to a clinician with appropriate training and experience in working with the psychological issues related to the empirically supported treatment of gender dysphoria (with some acknowledgement of the evolving nature of that research. Where such other clinicians are not readily available, the original clinician should work with the individual to identify and address and related or secondary concerns/co-existing conditions, emphasizing safety, without taking much of a stance on the gender dysphoria issue. Psychologists with appropriate training and experience should work closely with medical professionals who may or may not need to get involved with the case. Any planning for medical interventions should be done only following appropriate, research supported (with consideration to for the evolving state of such research) non-medical care. Because I am not up on the literature, I don't really have a firm stance on what should be done relative to non-adjudicated minors and medical interventions. Assuming- and maybe incorrectly- that nothing is done pre-pubescent- we are really talking about that aged 10-18 group. My reading of the literature would indicate that that is a VERY small portion of the population receiving any gender dysphoric related medical interventions.

I believe that the positions and behaviors of certain politicians (and others) is related to morals/religion/tradition/fear/etc., rather than any understanding of the actual clinical issues, effects of treatment/no treatment. I also believe that many of these same individuals purposefully equate gender affirming care with gender reassignment surgery, and wrongfully allude to such surgeries being performed on children. Further, i believe that many of these individuals (especially the politicians) due so to primarily to strengthen their own political standings with certain parts of the populace and have no real concern for the people affected by these policies. I also believe that there are psychologists and others who overstate the actual research findings (in both directions) to make it appear that their moralistically or religiously derived positions have more empirical support than they actually do. Some do so more intentionally than others.
Click to expand...
You read this whole one? Gender dysphoria in young people is rising—and so is professional disagreement

I think I had been linking to a shorter version
 
Heist said:
You read this whole one? Gender dysphoria in young people is rising—and so is professional disagreement

I think I had been linking to a shorter version
Click to expand...
I read the longer one, and it's still not really a research article, so much as its a journalistic article that cites a lot of secondary and tertiary sources--podcasts, position statements, etc. And the conclusion seems to be that there's not yet a lot of research on this, which... of course there's not--we've only been actually acknowledging that trans youth even exist as a valid identity for maybe one or two decades tops. Of course, best practice guidelines are still evolving in this relatively novel area of medicine.
 
Heist said:
You read this whole one? Gender dysphoria in young people is rising—and so is professional disagreement

I think I had been linking to a shorter version
Click to expand...
Thanks for clarifying and posting the longer version. Phew- I was concerned that anyone (even a psychiatrist😉) would've thought there was much of anything in that original version you posted!

I have read the longer article. it is still a piece of journalism (as opposed to a systematic review of the literature). As such, it has some significant limitations in what conclusions can be drawn from it. As As @futureapppsy2 mentions above, it relies heavily on secondary and tertiary sources. The further we get from the original data focused studies, the less we can be sure about the original findings and the methods used to obtain those findings (regardless of the conclusions). Being a journalistic piece (as opposed to a systematic review), the author also doesn't (and doesn't have to) specify their methods for choosing which sources to cite. Typically, a journalistic piece is organized around a thesis (in this case, something along the lines of "there is a concerning amount of disagreement around whether or not medical interventions for GDD should be used or not, to the extent that we should pull back on using such intervention"). The author then seeks out sources that support this thesis. Contradictory sources are usually cited to a lesser extent, and then things are wrapped up usually with a retort to the contradictory sources, with the original thesis being restated at the end in some kind of summary. This differs from a systematic review, where the methods for acquiring sources are provided so that we can determine the extent to which those methods would lead to appropriate representation of the overall population of sources. The systematic review is typically arranged around a question (e.g., "is there evidence supporting the use of hormone blockers in reducing the negative mental health aspects of GDD"). The author then employs a method for acquiring and reviewing a specified set of sources, and then compiles (or analyzes) the results of this sources in a manner that does not give favor to overlook sources supporting a specific viewpoint. As readers, we are privy to the all of the methods used and thus (with appropriate training and experience) are able to spot potential sources of bias in source compiling, analysis, and conclusions. We can then use that to guide our own interpretations of the systematic review. (Sorry for this basic explanation of what might be obvious or know to you or other trained posters. As the mission of this forum is, in part to inform and support trainees, I don't think it hurts to highlight some basic principles regarding what is and what isn't research).

In the case of this article (assuming the author is not being purposefully deceitful), all we know is that the US and it's professional associations/govt agencies support gender affirming care, up to and including medical interventions, while similar (but not identical) agencies some other countries (e.g., Sweden) have recently shown less support. We do not know, for example, why the positions of these countries were highlighted, but not those of, say, Belgium or Japan. If we are to take the stance of national boards as evidence of the correctness of any position, we- at a minimum- need to be provided the stance of all national health boards who have such a position. This article does not do that- I don't know if Sweden or the US is the outlier here, just from reading this article. It's a similar case with the study and research groups the author cites. The only real conclusion I can draw from this type of article is that there are differing views on the issue, potentially based on different research findings. As this is a hot-button, evolving, politically heated topic with moralistic and religious underpinnings, I just find that that conclusion unsurprising and rather uninteresting. My overall view of the issue as stated earlier in this thread (or maybe the other one on this topic) is unchanged after reading this article.

The article cite someone saying (and I paraphrase): "I'm concerned about an individual leaving their second session with script for hormone blockers." I find that a bit of strawman. If that scenario does, in fact, accurately portray "gender affirming care" then I am against gender affirming care. Something tells me, however, that that is an extreme- and likely fictitious, example. Including such statement in the article, with not qualifiers regarding whether or not that actually happens is more evidence that this piece is journalism, with the decisions about what to include or not to include based on how it supports a specific pre-drawn thesis. Before you all jump in and say "the other sided does that too"- DUH! Of course they do. That is what journalism is, and what distinguishes is from research or even news. I am not familiar with the editorial policies of BJM, but this article does clearly appear in the "Feature-BMJ Investigation" section rather than the "research" section, and as such is appropriately labeled. The appropriateness or utility of including journalistic pieces in a scientific journal (if in fact BMJ is thought to be a scientific journal) is debatable and a topic for another post.
 
futureapppsy2 said:
Intersex people are not the same as trans people, of course, and I never said that. The point is simply that how you identify "real" sex can be much blurrier than anti-trans folk admit. For example, they often say "it comes down to chromosomes", but if you have someone with androgen insensitivity syndrome, they have XY chromosomes but their genitalia at birth appears female, so are they "really" male or female? Would you go by external appearance? Identity? If so, why wouldn't you go by external apperance for a trans man or trans woman who appears to be male or female? No one is going to look at Hunter Schaffer and say "that's a man" or Laith Ashley and say "that's a woman" and if people were to see Laith Ashley in a women's bathroom, they would probably think "a man is using the women's bathroom!" not "yeah, that's a woman using the 'correct' bathroom." So, how "passable"/gender conforming do you have to be to be "really" male or female? I have a butch cisgender female friend who was sometimes mistaken for male during COVID due to masks and having smaller breasts. Should she have been using the men's bathroom because people might have mistaken her as a "male predator" in the women's bathroom? Again, what we've largely seen with bathroom bills in action is gender non-conforming cis people being attacked for following the law, which raises the question of where should they go to the bathroom? Should they even leave the house if they might be mistaken as trans?
Click to expand...
Still, inter sex is a medical condition that affects an astoundingly small portion of the population, much like kleinfengers syndrome and in those cases individuals still have a clear sex. This is obfuscating the real point of the argument of gender identity and trans identity today and how likely 99% of what were seeing is rapid onset gender dysphoria affecting vulnerable teenagers who have never exhibited any symptoms of dysphoria and politicians and activists and even our own field is pushing for medical intervention (which is not reversible and is harmful) for children as young as 13. While pushing the great lie to parents "would you rather have an alive daughter or a dead trans son". We know that in the overwhelming majority of cases, I think it was around 80% youth questioning their gender will either grow out of it (less likely) or actually wind up being gay (more likely). We are not seeing males or females who simply push the bounds of gender being attacked for following the law and the argument is far greater than bathroom bills. It is true that some individuals get caught in the gray areas of these discussions in which I think a valid solution is simply more gender neutral bathrooms and in cases or larger venues where any type of assault is highly unlikely just mind your business and let the person do their business.
 
Psychstudent!721 said:
Still, inter sex is a medical condition that affects an astoundingly small portion of the population, much like kleinfengers syndrome and in those cases individuals still have a clear sex. This is obfuscating the real point of the argument of gender identity and trans identity today and how likely 99% of what were seeing is rapid onset gender dysphoria affecting vulnerable teenagers who have never exhibited any symptoms of dysphoria and politicians and activists and even our own field is pushing for medical intervention (which is not reversible and is harmful) for children as young as 13. While pushing the great lie to parents "would you rather have an alive daughter or a dead trans son". We know that in the overwhelming majority of cases, I think it was around 80% youth questioning their gender will either grow out of it (less likely) or actually wind up being gay (more likely). We are not seeing males or females who simply push the bounds of gender being attacked for following the law and the argument is far greater than bathroom bills. It is true that some individuals get caught in the gray areas of these discussions in which I think a valid solution is simply more gender neutral bathrooms and in cases or larger venues where any type of assault is highly unlikely just mind your business and let the person do their business.
Click to expand...
I highly recommend reading this methodological critique of the study that gave rise to the ROGD hypothesis: Methodological Critique of Littman’s (2018) Parental-Respondents Accounts of “Rapid-Onset Gender Dysphoria”
 
ClinicalABA said:
I did. It's more of a position piece than a research article. I agree that it is important to be cautious with medical interventions and decisions really need to be made from an informed position where the benefits outweigh the costs. I do think that article presented stuff in a manner that overly equated "gender affirming care" with medical interventions (such as hormone replacement and surgery). There is certainly a lot of space between irreversible medical interventions and just telling kids to knock it off and start acting like a boy/girl. I have been pretty vocal against legislating against gender affirming care, but even I would say to proceed cautiously with medical interventions (especially irreversible ones) without some measure of certainty. Also- it's not terribly surprising/interesting to see increased professional disagreement when a topic becomes more popular, so to speak.

I was also struck by the following statement and how it applies to a lot of what I/we do:

"But without an objective diagnostic test, others remain concerned, pointing to examples of teenagers being “fast-tracked to medical intervention” with little or no mental health involvement. "

I bet I could show just that statement to 10 different psychologists and ask them to identify the topic/condition it referred to and I'd get around 5 different answers (e.g., ADHD, Bipolar, NSSI, even ASD). Problem is, at least with gender dysphoria, waiting for more more objective tests before doing anything can be untenable for many such individuals and lead to tragic outcomes.

I guess I would some up my position on this issue as follows: Individuals presenting to psychologists with gender dysphoria should be treated respectfully and cautiously, with some acknowledgement that issue really could be with the body and not the brain. These individuals should be referred to a clinician with appropriate training and experience in working with the psychological issues related to the empirically supported treatment of gender dysphoria (with some acknowledgement of the evolving nature of that research. Where such other clinicians are not readily available, the original clinician should work with the individual to identify and address and related or secondary concerns/co-existing conditions, emphasizing safety, without taking much of a stance on the gender dysphoria issue. Psychologists with appropriate training and experience should work closely with medical professionals who may or may not need to get involved with the case. Any planning for medical interventions should be done only following appropriate, research supported (with consideration to for the evolving state of such research) non-medical care. Because I am not up on the literature, I don't really have a firm stance on what should be done relative to non-adjudicated minors and medical interventions. Assuming- and maybe incorrectly- that nothing is done pre-pubescent- we are really talking about that aged 10-18 group. My reading of the literature would indicate that that is a VERY small portion of the population receiving any gender dysphoric related medical interventions.

I believe that the positions and behaviors of certain politicians (and others) is related to morals/religion/tradition/fear/etc., rather than any understanding of the actual clinical issues, effects of treatment/no treatment. I also believe that many of these same individuals purposefully equate gender affirming care with gender reassignment surgery, and wrongfully allude to such surgeries being performed on children. Further, i believe that many of these individuals (especially the politicians) due so to primarily to strengthen their own political standings with certain parts of the populace and have no real concern for the people affected by these policies. I also believe that there are psychologists and others who overstate the actual research findings (in both directions) to make it appear that their moralistically or religiously derived positions have more empirical support than they actually do. Some do so more intentionally than others.
Click to expand...
In terms of empirically-supported treatment of people with gender dysphoria I think I saw an article on use of DBT strategies published a couple of years back...will need to look it up.
 
zestyzigzagoon said:
I highly recommend reading this methodological critique of the study that gave rise to the ROGD hypothesis: Methodological Critique of Littman’s (2018) Parental-Respondents Accounts of “Rapid-Onset Gender Dysphoria”
Click to expand...
Yeah. Many people who should- by nature of their training as doctoral level psychologist- don't read past the abstracts (or the titles, for that matter) of the papers they cite in support of or against certain positions. Whereas all research studies have there limitations, some- like the Littman one- contain such major threats to internal validity so as to be pretty useless. The big issue with Littman is that, given the methods and subject recruitment procedures, it would be very surprising if they DIDN'T find what they did. I struggle as to whether this is intentional? Willful ignorance? Lack of research training?
 
Psychstudent!721 said:
Still, inter sex is a medical condition that affects an astoundingly small portion of the population, much like kleinfengers syndrome and in those cases individuals still have a clear sex. This is obfuscating the real point of the argument of gender identity and trans identity today and how likely 99% of what were seeing is rapid onset gender dysphoria affecting vulnerable teenagers who have never exhibited any symptoms of dysphoria and politicians and activists and even our own field is pushing for medical intervention (which is not reversible and is harmful) for children as young as 13. While pushing the great lie to parents "would you rather have an alive daughter or a dead trans son". We know that in the overwhelming majority of cases, I think it was around 80% youth questioning their gender will either grow out of it (less likely) or actually wind up being gay (more likely). We are not seeing males or females who simply push the bounds of gender being attacked for following the law and the argument is far greater than bathroom bills. It is true that some individuals get caught in the gray areas of these discussions in which I think a valid solution is simply more gender neutral bathrooms and in cases or larger venues where any type of assault is highly unlikely just mind your business and let the person do their business.
Click to expand...
Any source for 99% of these kids having ROGD? Fwiw, again, no one’s giving any medical transition treatment to kids, where the treatment is largely social transition. Adolescence gets a bit hairier, because the hormonal effects of puberty start coming into play, but the ROGD proponents I’ve seen rarely say “let’s hold off on medical treatment but I’ll totally support my child in dressing and identifying how they want and socially presenting in their preferred gender” but rather “my child could never be trans! I refuse to acknowledge it!” I’ve read ROGD perspectives to better understand them, and I have to say, the vast majority essentially boil down to transphobia when you scratch the surface even a bit, because they aren’t saying “let’s take a cautious approach with initiating medical treatment” (which has pros and cons with anything you treat medically, especially something with emerging literature like this), but rather, “no way are these people trans! Nope! Never!”
 
When someone quickly switches between "we need to protect our women and children from men masquerading as women" and "99% of it is ROGD, and 80% will outgrow it" I start to think that person just doesn't like trans individuals and is searching for anything to support a moralistic positions. Moralistic positions are ones prerogative, I just wish people would own up them. I shall now do so:

I have ho moral or religious objections to trans or any other LGBTQ related issues. I believe our world would be a better place if we stopped persecuting LGBTQ individuals. I feel my community is a better, more interesting, and more vibrant place when it includes LGBTQ individuals who feel free to be who they want to be, openly and freely. I don't believe myself, my children, or other children in my community are at risk of harm because of this, not do I feel anyone is risk of "being recruited to this lifestyle. I also acknowledge that the media I consume, discussions I engage in, and work I do is influenced by my beliefs. I also admit to having no active religious beliefs related to this- or any other- topics.
 
I would find many of the arguments against gender-affirming care more palatable if it came with an attitude of "These procedures aren't easily reversible so let's just make sure we are erring on the side of caution with youth while still respecting their feelings and fully supporting their desire to live life as they choose once they become adults."

While I'm certain there are people out there with that attitude, I have seen extraordinarily few opponents to gender-affirming care in children who are truly supportive or welcoming of adults transitioning. It certainly makes me question their real motives.
 
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